The Needs Assessment

is completed on admission by the Child’s Children’s Services Worker or the Adult most involved with the Child. This assessment consists of 103 items and evaluates the Child’s psychosocial history and areas of difficulty. The Needs Assessment and the Indictors of Success are completed upon admission and annually thereafter. The results used to establish Foster Plan of Care goals and monitor outcomes.

The Strength Assessment

is based on the 40 Developmental Assets associated with successful progress into adulthood. Where a client possesses a particular asset, it may be incorporated as a strategy to achieve a particular goal. Where an asset is underdeveloped or absent, establishing a particular strength may be the goal.

The Risk Assessment

is based on objective, psychometrically sound tools and related to the populations we serve. Different client populations may receive a different combination of the tests listed below.

The Risk component uses a multi-gate method which measures Threshold A) premorbid conditions which measure the health & safety domain and; Threshold B) catalytic factors which measure the Child’s and family’s ability to cope. Both the premorbid risk factors and the catalytic risk factors are predictive of escalating problems and adverse outcomes across the life span.

Threshold A: The Health and Safety domain is measured by:

  • Children’s Global Assessment Scale (CGAS)Child’s social impairment
  • Conners’ Global IndexChild’s behaviour problems
  • SA-45 or FAB-CChild’s psychiatric symptomology
  • The Children Autism Rating Scale (CARS)Degree of autistic symptomology
  • The Level of Assistance (LA)Degree of medical support required

The central belief of the tests at Threshold A is that a Child’s health and safety is compromised by one of five fairly distinct and uncorrelated conditions: (1) chronic behaviour problems, (2) an inability to function at home, in school or in the community, (3) the presence of high levels of anxiety, worries, depression and disquieting thoughts, (4) evidence of autistic symptoms and (5) the presence of medical & or physical conditions requiring direct intervention for the Child to function at the most basic level.

Threshold B: The Child/Youth’s or the family’s ability to cope is measured by:

  • The Child Objective Stressors ChecklistThe Child’s experience of stress
  • The QRS-FThe parent’s experience of stress
  • A sociodemographic checklistAdverse family history
  • Parental Bonding InstrumentQuality of attachment
  • Vineland Adaptive Behaviour Scale (VABS)Child’s developmental functioning

The central belief behind the second threshold is that the probability that the Child will get worse without intervention is determined by a combination of (1) The Child’s current stress levels, (2) The Parent figure’s current stress levels, (3) The accumulation of very stressful events and adverse conditions from early life, (4) The quality of the Child’s attachment to his or her primary care givers; and (5) The Child’s acquisition of basic skills in communication, socialization, daily living and motor development compared his peers.

No Child will receive all of the tests under each threshold. At a minimum each Child will be given one test per threshold. In most cases, a Child will be given 2 tests in each Threshold and the highest (or greatest risk score) is the result used in the classification of risk according to the following rules:

  • Very High Risk = both thresholds in the high risk zone
  • High Risk = combination of high and moderate risk across both thresholds
  • Moderate Risk = both thresholds in the medium zone or a combination of high-low across the 2 thresholds
  • Low Risk = both thresholds in the low risk zone or a combination of moderate-low across the 2 thresholds

The Risk of Restraint Assessment

is another multi-gate assessment that evaluates the risk of injury in a restraint and the probability of the Child requiring a restraint. The first threshold – risk of injury – evaluates the risk of injury to the client involved in a restraint based on such factors as medical/health issues, medication, and psychiatric symptomology. The second threshold -probability of a restraint -evaluates the likelihood that a Child will engage in imminent risk behaviours requiring a restraint based on such factors as past history of restraints, severity of behavioural and emotional problems, and level of functioning. The degree of risk of restraint (High, Moderate, Low) is discussed with the Child and/or their guardian and where necessary, specific crisis interventions are modified to minimise both the probability of a restraint and the risk of injury to everyone involved.

Outcome Measures

The outcomes for the Child are measured in two ways:

  1. By changes in the individual scores on the Risk-Needs Assessments; Strength Assessment; Academic Achievement; and the Indicators of Success. The Risk assessment is completed every 6 months prior to the next scheduled Foster Plan of Care. Needs and Strength Assessments, Academic Reviews, and Indictors of Success are completed annually as part of the Child’s Annual Case Review.
  2. By observing changes in the Foster Plan of Care, i.e., the meeting of goals and the effectives of the tasks and strategies employed in accomplishing the goals. These outcome measures are noted at each plan of care and reviewed annually as part of the Child’s Annual Case Review.

Outcome reports are reviewed with the Treatment Team and used to guide the Child’s treatment plan.